Breanna Shaffer, PHARM. D

Primary specialty

PharmacistTaxonomy code 183500000X

License

5302037046 Issued in MI

Practice address

5500 Clyde Park Ave SW
Wyoming, MI 49509-9525

Phone

(616) 531-9629

NPI assigned

Nov 10, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1289347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386028800000",
    "number": "1497056261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2259 MAPLEROW AVE NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495342708",
            "telephone_number": "616-307-5106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 CLYDE PARK AVE SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495099525",
            "telephone_number": "616-531-9629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFFER",
        "first_name": "BREANNA",
        "name_prefix": "Dr.",
        "credential": "PHARM. D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-10",
        "last_updated": "2013-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "13120",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302037046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mkrtich Serobyan, DO
• Karlin Edith Sevensma, D.O.
• Matthew Warren Sevensma
• Susan C. Sevensma, D.O.
• Callie Seymour
• Dawn Lynn Shaffer, MA
• Muhammad Talha Shahzad, DO
• Holly J Shank, PA C
• Soorya Kant Sharma, MD
• Ashlee Sharpe

• Pharmacist in Wyoming, MI
• Providers in Wyoming, MI by specialty
• Pharmacist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.